New Jersey legalizes medical marijuana

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(Source – Philly.Com 1.19.10)  With New Jersey’s endorsement of medical marijuana, there may be no stopping the rehabilitation of cannabis from illegal drug to legitimate therapy.

Late yesterday, Gov. Corzine signed a law making New Jersey the fourteenth state to legalize medical pot. Four more states and the District of Columbia are expected to follow suit by year’s end.

Many things are driving this sea change. The federal government last year announced that it would no longer prosecute medical marijuana smokers in states where it is legal, while the National Institutes of Health has begun funding research on medicinal use in a reversal of a long-standing policy.

Gallup Polls show a solid majority of Americans sympathetic to therapeutic marijuana use.

And the usually conservative American Medical Association, along with the Philadelphia-based American College of Physicians, has joined other medical groups in calling for research and development of cannabinoid-based medicines.

Lawyer Keith Stroup, who founded the National Organization for the Reform of Marijuana Laws (NORML) in 1970, rejoiced: “We’ve had more political progress and public support in the past three years than in the previous 30. We’ve largely won the hearts and minds of Americans.”

Paul Cohen, a physician and lawyer who teaches public health law at Georgetown University, said, “I think we’re pretty close to the tipping point.”

California’s famously liberal medical marijuana law allows the use, possession, and cultivation of marijuana by anyone who possess a “written or oral recommendation” from their physician that he or she “would benefit from medical marijuana.”

In contrast, New Jersey’s version requires patient identification cards and state-monitored dispensaries – easing fears that medical use will fuel illegal sales and teenage substance abuse.

“That’s the exciting thing about New Jersey,” Cohen said. “Maybe people’s minds will be clearer about the debate.”

Pennsylvania is not expected to pass a similar law anytime soon, although Rep. Mark B. Cohen (D., Phila.) last year introduced a bill in the House.

Assemblyman Reed Gusciora, a Democrat from Princeton who sponsored the New Jersey legislation, thinks his bill strikes the right balance between compassion and caution.

“I’m sure college campuses would prefer the California model,” he said. “But we made New Jersey’s law illness-specific. And the prescription has to be from an actual physician.”

New Jersey’s law allows marijuana prescriptions for cancer, AIDS, glaucoma, multiple sclerosis, muscular dystrophy, and other diseases in which patients suffer “severe chronic pain, severe nausea, seizures, or severe and persistent muscle spasms.”

Cannabis preparations have been used to relieve nausea and pain since ancient times. But over the last 15 years, research on the body’s cannabinoid receptors has begun to decipher the chemistry and biology of these good effects. More recently, clinical trials have shown that these benefits outweigh the concerns about addiction, heart and respiratory diseases, cancers, and psychoses – at least, with short-term use.

Many questions, however, remain to be answered, experts say. One of the biggest is whether smoked medical marijuana could be replaced by a pharmaceutical version.

Marinol, a synthetic cannabinoid pill, is approved by the Food and Drug Administration for treating AIDS-related wasting and chemotherapy-related nausea. But many patients say choking down a slow-acting pill simply doesn’t provide the convenient and immediate relief of inhaling pot.

A new drug, Sativex, made by GW Pharmaceuticals, may renew the question. A cannabinoid-based oral spray, Sativex is approved in Canada for treating pain in multiple sclerosis and advanced cancer. The company is now completing the clinical testing needed for approval in Europe and the United States.

“If I were an advocate of medical marijuana, and if Sativex is approved, I would then try to set up a study to show smoked marijuana is better,” said Paul Cohen – who, at 75, said he has never tried pot.

Last year, Cohen wrote a law review article criticizing both the government’s stubborn criminalization of all marijuana use and individual states’ defiant efforts to legitimize medical use.

“Instead,” Cohen wrote, “the FDA should . . . evaluate medical marijuana with the same methodology, standards, and diligence that the agency would apply to any other investigational drug.”

Just one problem: No pharmaceutical company or advocacy group has stepped up to do the rigorous and costly human testing that would give the FDA data to evaluate.

And no one is likely to. Medical marijuana is winning the war of public sentiment, never mind the war on drugs.

Stroup, 66, attributes this to generational changes.

“My generation believed in ‘Reefer Madness,’ ” he said, referring to the 1937 film in which high school marijuana use led to addiction, murder, suicide, and insanity. “Over the last 22 years, half of high school graduates have experimented with pot. The majority don’t smoke when they get married and have kids, but they have smoked, and they know it didn’t turn them into heroin addicts.”

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